Provider Demographics
NPI:1275012148
Name:GUILFORD HOLISTIC HEALTH PRACTITIONERS, LLC
Entity Type:Organization
Organization Name:GUILFORD HOLISTIC HEALTH PRACTITIONERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLASS
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:203-453-1906
Mailing Address - Street 1:5 DURHAM RD STE B6
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2076
Mailing Address - Country:US
Mailing Address - Phone:203-453-1906
Mailing Address - Fax:203-453-2012
Practice Address - Street 1:5 DURHAM RD STE B6
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437
Practice Address - Country:US
Practice Address - Phone:203-453-1906
Practice Address - Fax:203-453-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000058261QM2500X
261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty